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General NPI Number Information
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NPI Number | 1710487368
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Entity Type | Individual
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Provider Name | ABU SANNOH
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Gender | Male
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 1605 E EVESHAM RD STE 100B
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City | VOORHEES
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State | NJ
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Zip | 08043-1437
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Country | US
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Telephone | 856-355-7118
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Fax | 856-355-7116
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Provider Business Mailing Address
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Address Line | 623 FOREST EDGE
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City | DEPTFORD
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State | NJ
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Zip | 08096-2947
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Country | US
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Telephone | 856-537-4684
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Fax | 856-762-2876
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05325000
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License Number State | NJ
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